胃癌术后胆囊结石形成的相关因素及预防

【摘要】 目的:探讨胃癌术后胆囊结石发病率明显增加的原因及处理原则。方法:彩超定期随访622例胃癌术后患者,跟踪术后胆囊结石出现的时间,分析不同的手术方式、消化道重建方式及淋巴结清扫范围与胆囊结石形成的关系,并进一步随访术后胆囊结石的变化情况及处理方式。结果:18.0%(112/622例)的随访患者并发胆囊结石,69.6%(78/112例)在术后2年内发现;胃癌术后胆囊结石形成与手术方式、消化道重建方式无关,与淋巴结清扫范围密切相关(D1+组与D2+组比较,P=0.011;D2组与D2+组比较,P=0.021),大部分患者(82.1%,92/112例)并不出现胆石症状。结论:淋巴结清扫范围是胃癌患者术后并发胆囊结石的危险因素,因此对于需行广泛淋巴结清扫的患者,可考虑预防性行胆囊切除。更多还原

【Abstract】 Objective:To explore the causes and the treatment of Gallstone Formation after Gastric Cancer Surgery.Methods:Gallstone formation was confirmed by ultrasound examinations that were routinely carried out after surgery on a periodic basis.We evaluated the influence of gastrectomy,reconstruction,and lymph-node dissection on the incidence of gallstone formation after gastrectomy.Furthermore,we invested the development and treatment of gallstone formation after gastrectomy.Results:Gallstone formation occurred in 18.0%(112 of 622)patients who had undergone gastrectomy.Gallstones were usually formed within 2 years after gastrectomy.The types of gastrectomy and reconstruction had no significant effect on the incidence,but the extent of lymph-node dissection was a significant factor(D1+ vs.D2+:P=0.011;D2 vs.D2+Pp=0.021).In most cases,gallstone formation was asymptomatic.Conclusion:The extent of lymph-node dissection was a risky factor in gallstone formation after gastrectomy;therefore,prophylactic cholecystectomy should be considered in cases of extensive lymph-node dissection.更多还原